Re: L. (J.)
ORB File No: 8151
Hearing held on: Tuesday, March 10, 2026
Place of hearing: Centre for Addiction and Mental Health
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. J. Weinstein
Members: Dr. R. Wood Hill Dr. G. Nexhipi Dr. K. Connidis Mr. A. Mete
Parties Appearing:
Accused: L. (J.) Counsel: Mr. A. Procope
The person in charge of hospital: Counsel: Ms. M. Warner
Attorney General of Ontario: Counsel: Mr. D. Brandes
*Pursuant to s. 672.501(1) of the Criminal Code, the Ontario Review Board prohibits the publication, broadcasting, or other transmission of any information that could identify a victim in this matter or a witness who is under 18 years of age.
REASONS FOR DISPOSITION
(Dated March 24, 2026)
Introduction
On September 16, 2022, Mr. L. (J.) was found not criminally responsible on account of mental disorder, (“NCR”) on a charge of sexual assault, contrary to the Criminal Code of Canada (“Criminal Code”).
L. (J.) is subject to a Disposition of the Ontario Review Board (the “Board”) dated February 27, 2025, which orders that he be detained at the Forensic Service of the Centre for Addiction and Mental Health, Toronto (“CAMH”).
This Disposition provides him with the privilege to live in the community in accommodation approved by the person in charge.
On March 10, 2026, the Board convened a hearing at CAMH to conduct the annual review of the current Disposition.
L. (J.) was present at the hearing and was represented by his counsel, Mr. A. Procope.
A Hospital Report, dated February 17, 2026 (the "Hospital Report"), was entered as Exhibit 1.
The issues at this hearing were whether L. (J.) presents a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code, and, if so, what is the necessary and appropriate Disposition in the circumstances, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.
For the reasons set out below and based on the expert evidence and opinions before us, the Board concluded that L. (J.) continues to represent a significant threat to the safety of the public. The Board found that the necessary, and appropriate, Disposition in the circumstances is the continuation of the existing Detention Order.
Current Psychiatric Diagnoses
- Schizophrenia
Cannabis Use Disorder
Antisocial Personality Traits
Index Offence
- The circumstances giving rise to the Index Offence are extracted from last year’s Board Reasons, as follows:
“On October 20, 2020, at approximately 10:10 a.m. the police attended the Trillium Hospital responding to a sex assault call. On arrival, the police spoke with the victim who advised that she was sitting in the hospital waiting room alone when she observed an unknown male also in the waiting room. The victim advised police that without warning the male ran towards her, got down on his knees in front of her, put his hands around her waist area and started pulling down her pants from the waist area.
The victim struggled for a short time with the male before hospital security intervened and got the male off of the victim. The victim advised police that the male did not talk or say anything to her during the incident and although he was able to partially remove her pants, she does not know what his intentions may have been for removing her pants. The victim advised police that her underwear was not removed, her genitals were not exposed and she was also not physically injured as a result of the incident.
L. (J.) was apprehended by hospital security and held on a Form 1 in the mental health ward. The police were unable to speak with the male as he had been sedated by hospital staff.”
Criminal, Substance Abuse, Personal, and Psychiatric Histories
- L. (J.)’s criminal, substance abuse, personal, and psychiatric histories are set out in detail in the Hospital Report, and they are accurately summarized in last year's Reasons:
“L. (J.) has a sizable criminal record spanning from 2006 to 2021 involving four charges of assault, three charges of sexual assault, two charges of criminal harassment, possession of a controlled substance and mischief under $5,000.
L. (J.) started using cannabis in grade 10 at the age of 15. He smoked up to three to four grams daily with the heaviest use at age 19 to 21. He started drinking alcohol at age 14 and drank occasionally to the point of intoxication. He did not perceive his alcohol consumption was problematic.
L. (J.) was born in Etobicoke, Ontario. He never resided with his father and last saw him at age 18. He was raised in the family home with his maternal grandparents. L. (J.) was raised in a Pentecostal Church community and stated that his family members were devoutly religious. When L. (J.) was age 11 his mother moved to Atlanta to pursue a Master’s Degree in public health. L. (J.) reported having a difficult childhood during which he was abused by his grandmother, uncle, and mother, his uncle using corporal punishment to discipline him. The mother resided in Atlanta from 1996 to 2008 when she returned to Canada to support her son with his mental illness.
L. (J.) moved to Atlanta to stay with his mother at age 17 for about seven months where he attended grade 10. He returned to Toronto where he attended grade 11 and completed two grades short of graduating from grade 12. He began having mental illness symptoms and his medications caused him to be drowsy during the day so he failed to complete some courses. As for employment, L. (J.) worked at several short-lived general labour jobs from which he got fired for poor performance. He admitted to smoking cannabis on the job.
L. (J.) has not had a sustained intimate relationship with a partner. He claims that his medications have caused erectile dysfunction.
L. (J.) has a lengthy psychiatric history having 15 psychiatric admissions at several hospitals from 2004 to 2010. Over the years until L. (J.) was admitted to CAMH in November 2022 after the index offence, he had been admitted and discharged off and on at various times to Credit Valley Hospital, Etobicoke General Hospital, Brampton Civic Hospital, Oakville Trafalgar Memorial Hospital, St. Joseph’s Hospital, William Osler Hospital, Trillium Hospital, Halton Health Care and CAMH.
At times at the hospitals, L. (J.) was agitated such that on some occasions he had to be subdued by physical and chemical restraints. He was diagnosed with paranoid schizophrenia and prescribed anti-psychotic medication at the various psychiatric facilities which medications continued to be adjusted to optimize their effect. He displayed no insight into his illness or need for medication and would refuse to comply with his medication regimen. L. (J.) often presented as confused, dishevelled and talking to himself.
On admission to the hospital L. (J.) exhibited command auditory hallucinations after not taking his medication. He smoked cannabis and engaged in various forms of inappropriate, at times, violent behaviour at his residences and in public exhibiting various types of bizarre behaviours. His delusions were often motivated by erotomania as he frequently exhibited hypersexuality, making sexually inappropriate comments and touching females in his midst at correctional facilities, hospitals and in public. His delusions were often grandiose such as at William Osler when he proclaimed he was a part of the "Superman network" and that he was a prophet.
L. (J.) would also become withdrawn, uncommunicative, uncooperative, and hypervigilant, with no insight into his delusions. At Oakville-Trafalgar Memorial Hospital he demanded to leave the hospital causing him to be committed involuntarily requiring physical and chemical restraints. He referred to marijuana as his "medication", and stated that he was God and that God told him that he did not need psychiatric medication.
L. (J.) was discharged to supported independent living in the community in July 2015. He gained employment and was medication compliant and stabilized on his anti-psychotic medication. From January 2017 to January 2018 he was transitioned to the Downtown West ACT team under the care of Dr. Leblanc. He did well, did not require hospitalization and received an absolute discharge on January 22, 2018.
However, L. (J.) started to decline on the absolute discharge and did not tell the team of his symptoms but told a worker that he was not taking the required dosage of his medication. He was admitted and discharged from several hospitals for violent and bizarre behaviours and, as noted previously, in 2022 he was ultimately found not criminally responsible for the October 2020 index offence and admitted to CAMH.”
Course Since Last Disposition
- L. (J.)’s course since his last Disposition is set out in detail in the Hospital Report. The following extracted paragraphs are relevant to this hearing:
“L. (J.) had a stable reporting year from a psychiatric perspective. He was consistently assessed to be in remission with respect to psychotic symptoms including disorganization, delusional ideation and perceptual disturbances.
L. (J.) faced several significant changes within his family, housing, and financial circumstances in the last year, which he coped well with overall. His mother died in August 2025 after a period of medical illness.
L. (J.) reported a historical debt totaling approximately $12,000 in overpaid CERB funds, which he planned to repay after he received outstanding inheritance monies from his mother’s estate.
L. (J.) moved from a high support residence to more independent housing in June 2025, to better match his needs. L. (J.) remained independent in both basic and instrumental activities of daily living, requiring minimal prompting or intervention from housing or FOPS staff. Subsequent to L. (J.)’s move, there were no issues noted overall by housing staff and he was assessed to have adjusted well overall to the new milieu.
In terms of substance use, L. (J.) maintained abstinence from substances for most of the reporting year.
Regular urine drug monitoring corroborated L. (J.)’s reported substance abstinence until February 12, 2026, when his urine tested positive for cannabis. He subsequently acknowledged using cannabis impulsively the night before with a woman whom he met in a romantic context.”
Position of the Parties
Counsel for the hospital, for the Attorney General, and for L. (J.) advised that this was a joint submission. All were adopting the hospital’s recommendation of a continuation of the existing Detention Order Disposition.
For the purposes of this hearing, counsel for L. (J.) advised that significant threat was not in dispute.
Evidence at the Hearing
- The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. Arnold. Dr. Arnold testified as follows:
a) He is a PGY-6 Forensic Psychiatric Fellow working under the supervision of Dr. Ali.
b) He has been working with L. (J.) since July 1, 2025.
c) He met with L. (J.) on March 5, as L. (J.) wanted to discuss the side effects he was experiencing from his injectable medication. L. (J.) was complaining about sedation, sleep disruption, and negative metabolic effects.
d) L. (J.) requested a switch to the oral antipsychotic, Olanzapine, which he had taken in the past. It is his strong clinical opinion however, that L. (J.) should remain on his current medication regimen, noting that it has been associated with a significant improvement in his psychiatric stability over the last three years. The major concern he has with switching L. (J.) to an oral medication, is that L. (J.) has historically been non-adherent to oral antipsychotics.
e) He will continue discussing any change in the medication regimen with L. (J.), who is capable to consent to treatment.
f) This is L. (J.)’s second time being under the Ontario Review Board.
g) In the past, there were several instances when L. (J.) was taking oral medications but struggled to adhere to them, and subsequently discontinued their use without the treatment team’s involvement. These non-adherences were linked to decompensations including many hospital admissions as well as offending behaviour.
h) His first time under the Ontario Review Board, when he was found NCR in 2010, was because of an Index Offence he committed when engaging in polysubstance abuse, and simultaneously being non-adherent to his antipsychotic treatment.
i) When L. (J.) received an Absolute Discharge in 2018, and prior to his second finding of NCR in 2022, he stopped his oral medication. This resulted in police involvement and a series of civil psychiatric admissions up until the time of being found NCR in 2022.
j) The transition to a new, more independent and non-transitional housing residence in June was handled very well by L. (J.). The residence has staff on-site daily between 9:00 a.m. and 8:00 and a dedicated housing worker who meets with L. (J.) twice daily.
k) L. (J.) faced several stressors over the past year, including the death of his mother. As a result of this death, L. (J.) received a substantial financial inheritance which prompted an end to his ODSP support. He is now paying for his accommodation himself at market rent. This also could have been a destabilizing factor for L. (J.), but he coped admirably with this change.
l) There was one instance of cannabis use after more than a year of abstinence. This resulted in a temporary change in L. (J.)’s mental status. He became overly familiar, and exhibited pressurized speech and elevated affect. Subsequently, increased monitoring was implemented, which resulted in urine screens quickly returning to negative, no prolonged decompensation, and no hospital admissions.
m) L. (J.) acknowledged the risk cannabis poses to his mental health and demonstrated insight after the event. He also acknowledged that this one-time use of cannabis was an unplanned event and an impulsive decision. He had an interaction with a woman in whom he was romantically interested, and it was her idea that they smoke cannabis together. She insisted that in order for them to continue interacting, they both needed to be engaged in cannabis use.
- In response to questions from counsel for L. (J.), Dr. Arnold testified:
a) L. (J.) just recently raised the possibility of changing his medication regimen. The treatment team has not yet had the opportunity to fully explore alternatives with L. (J.).
b) The benefit of medication is recognized by L. (J.), but he still gets frustrated with side effects, and how medication interferes with the quality of his life.
- In response to questions from the panel, Dr. Arnold testified:
a) While L. (J.) does get frustrated over his inability to use cannabis, he does have insight into how it can negatively affect his mental stability, and why it is important to remain abstinent.
b) L. (J.) has completed substantial programming and understands the connection between substance use and his risk to public safety.
c) Last year’s Reasons noted that at the time of admission L. (J.)’s delusions were often motivated by erotomania, as he frequently exhibited hypersexuality, made sexually inappropriate comments, and touched females in his midst at correctional facilities, hospitals and in public; he has shown little or no empathy for the women harmed by his conduct; and noted also that Dr. Tyagi’s Psychological Testing Report, using the STATIC-99R, indicates that L. (J.)’s history shows preoccupation and acting-out behaviours against adult females as well as sexually disinhibited conduct in public resulting in complaints to police evidencing history of sexual dysregulation. However, they have not seen this behaviour when L. (J.) has not been psychotic.
d) Should L. (J.) be transitioned to a new medication regimen, the treatment team will have to consider whether this can be done safely in the community with less supervision, or if he will require a more supervised in-hospital transition to monitor his stability.
e) Even though L. (J.) has inherited a substantial amount of money, he does wish to re-engage in vocational or educational programming aimed at gaining employment. This is commendable as it shows that he is realistic as to his future plans.
- No other evidence was called.
Analysis and Conclusions
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees with the joint submission: L. (J.) remains a significant threat to the safety of the public.
In Winko, the Supreme Court outlined that, in coming to the conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence, including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the NCR accused’s medical condition; the NCR accused’s own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by experts who examined the NCR accused. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Arnold, in addition to the documentary evidence before us.
L. (J.) has a longstanding and well documented history of schizophrenia. When unwell, he has experienced functional decline, disorganized and antisocial behaviour, and delusional content (often paranoid and religious). He has exhibited violent and sexually inappropriate behaviour in the context of active psychotic symptoms.
L. (J.) has a history of problems with violence, relationships, employment, substance use, major mental disorder, traumatic experiences, and treatment or supervision response.
L. (J.) is said to express a long-time goal of interest in a successful intimate relationship. However, he has not expressed an interest in accessing more supports around this. It was noted that there are women staff on his treatment team but there does not appear to have been any issues. Dr. Arnold indicated that since he has been involved in his care, there has not been any “substantial concern” pertaining to this issue. It was his opinion that the destabilizing influence of substance abuse and psychosis contributed to disinhibition which gave rise to the hypersexuality and sexual aggression. In the past he has wanted to stop medication due to decreased libido and erectile dysfunction, but this is not the case currently.
As set out in the Hospital Report, L. (J.) has had recent problems with stability. He also has had problems with insight and ability to follow-up with treatment. He has not had recent problems with symptoms of his major mental disorder or violent attitudes.
L. (J.)’s recent cannabis use resulted in a noticeable change of his mental state.
L. (J.) has requested a change to his medication regimen because of the numerous side effects that he is experiencing. This change in medication needs to be approached very carefully under the auspices and the review of a treatment team.
In particular, the Board relies on the following extracted paragraphs set out in the Hospital Report:
“Overall, if L. (J.) were to remain under his current conditions, his risk of future violence and serious physical harm would be low. His risk of imminent violence is low. As with the previous reporting year, L. (J.) would be at high risk of future violence without the oversight of the ORB and external controls. This is due to his previous history of multiple readmissions to hospital for psychotic decompensation associated with aggressive and assaultive behaviour shortly following his absolute discharge in 2018.
Re-offence Scenario
In risk assessment, one of the best predictors of future violence is a patient’s history of violence. If L. (J.) were to reoffend, it would likely be in the context of medication non-compliance and subsequent psychotic decompensation, as well as psychotic symptoms exacerbated by substance use. In the absence of external monitoring, he will likely disengage with services, use substances and become non-compliant with medication, which will increase his risk of relapsing into a psychotic episode, similar to his mental state at the time of the index offence. It is noted that following his absolute discharge in 2018 where there was no longer external control form the ORB, L. (J.) had multiple readmissions to hospital for psychotic decompensation and displayed aggressive and assaultive behaviour towards others.
Given L. (J.)’s history of mental illness, previous violence while unwell, and risk assessment scores, he continues to meet the threshold for significant threat as defined in Section 672.5401 of the Criminal Code.”
In light of the Board’s finding of significant threat, it is charged with shaping a Disposition for the coming year.
We agree that without the external supervision provided by this Board, L. (J.) would become non-adherent to his medication regimen and disengage from services. He also has a history of using substances, which exacerbates his psychosis. For these reasons, the hospital needs to retain the ability to approve L. (J.)’s housing. The Mental Health Act is more reactive than proactive, and L. (J.)’s use of substances would not allow the hospital to intervene quickly enough in order to prevent him from becoming a risk to public safety. Because the balance of significant static violent risk variables and ongoing dynamic risk variables, he is best managed under a Detention Order.
In consideration of all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of L. (J.), his reintegration into society and his other needs, the necessary and appropriate Disposition is to continue with a Detention Order.
DATED this 24th day of March, 2026, at the City of Toronto, in the Region of Toronto.
Mr. J. Weinstein Alternate Chairperson
Office of the Registrar Ontario Review Board